Patient History• 31-year-old female• She had a "motion-sparing" device placed for degenerative disk disease in an off label application.• According to the patient, she had in situ fusion. The patient was told she had a motion-sparing device but fusion was done anyway. The patient then went on to hardware failure. She had increasing low back pain and never got better from the index surgery. She came to me with failed hardware, broken screws and obvious pseudarthrosis. The patient has a very difficult history and this complicates the overwhelming picture of low back pain, failed instrumentation, Dynesys use with in situ fusion and unclear application of technology.